NPI | 1467859033 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 34933) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: TX 1252236) |
Enumeration Date | 2014-11-26 |
Last Update Date | 2022-06-15 |