| NPI | 1578966339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 6860) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 1999140687) |
| 225100000X Physical Therapist (Licence: MA 19604) | |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2024-10-30 |