| NPI | 1114696606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI HI-5273) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2021031361) |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2024-03-07 |