| NPI | 1619609674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-7404) |
| Additional Taxonomies | 2251P0200X Physical Therapist Pediatrics (Licence: ID PT-7404) |
| 2251X0800X Physical Therapist Orthopedic (Licence: ID PT-7404) | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2024-09-23 |