| NPI | 1508308297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 0906) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 1717) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2022-08-28 |