| NPI | 1134890908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305215032) |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2022-10-13 |