| NPI | 1528609781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872546) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 12428) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2023-12-18 |