| NPI | 1104546399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 16642-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 39352) |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2024-05-23 |