| NPI | 1225574379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212423) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 43405) |
| 225100000X Physical Therapist (Licence: OR 62048) | |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2023-10-03 |