| NPI | 1215403175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-7471) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0015941) |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2021-08-11 |