| NPI | 1548640907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 09766R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH 4837) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2024-08-15 |