| NPI | 1316511991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP007870T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2021033485) |
| 225100000X Physical Therapist (Licence: GA PT014791) | |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-09-29 |