| NPI | 1437821758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 05227) |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-10-05 |