| NPI | 1225648587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP015026T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P19514) |
| 225100000X Physical Therapist (Licence: FL PT35867) | |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2022-09-08 |