| NPI | 1619564614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 12857) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS 6908) |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2024-03-11 |