| NPI | 1134837875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29217) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE CP022275T) |
| 261QR0400X Clinic/Center, Rehabilitation (Licence: DE CP022275T) | |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2023-10-12 |