| NPI | 1578536769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 3590024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 3590-24) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2021-09-11 |