| NPI | 1245990597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2021019717) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 7274) |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2021-12-28 |