| NPI | 1093484610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070026256) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 041478563) |
| 261QS1000X Clinic/Center, Student Health | |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2021-12-02 |