| NPI | 1386077618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216324) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 291336) |
| 225100000X Physical Therapist (Licence: NC 14432) | |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2024-09-18 |