| NPI | 1285373001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 27616) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 004507) |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2024-06-21 |