| NPI | 1417696535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12276) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 114750) |
| 225100000X Physical Therapist (Licence: NC P22943) | |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2024-03-19 |