| NPI | 1376239756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA CP021288T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT014601) |
| Enumeration Date | 2023-04-18 |
| Last Update Date | 2023-04-18 |