| NPI | 1447928296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 6097) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 297603) |
| Enumeration Date | 2021-09-04 |
| Last Update Date | 2021-12-24 |