| NPI | 1164208070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12428) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT40791) |
| 225100000X Physical Therapist (Licence: VA 2305216212) | |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2024-11-18 |