| NPI | 1356969414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 12688) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0134545PROV) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2023-03-24 |