| NPI | 1104442797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0014925) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT003022E) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2024-12-29 |