| NPI | 1487491569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2024032325) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-08-30 |