| NPI | 1528772977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214981) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2024-10-07 |