| NPI | 1497367494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT6466) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MS PT6466) |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2021-01-19 |