| NPI | 1295178259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PR 1115) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: PR 1115) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2024-06-19 |