| NPI | 1164208070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216212) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT40791) |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2024-01-04 |