| NPI | 1255896130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P21149) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT027479) |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2022-05-09 |