| NPI | 1366193591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP010213T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 111761) |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-01-24 |