| NPI | 1134858368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2022-06-05 |
| Last Update Date | 2022-06-05 |