| NPI | 1366816795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 10116) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305209419) |
| 225100000X Physical Therapist (Licence: NC P16355) | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2022-05-19 |