| NPI | 1134596497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209645) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P16761) |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2025-02-05 |