| NPI | 1124549407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 16414) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC 2024) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-07-21 |