| NPI | 1447773718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208658) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT012160) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2023-11-15 |