| NPI | 1205389871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 11044) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 11957) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2023-08-08 |