| NPI | 1619703147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P23622) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT032519) |
| Enumeration Date | 2024-09-11 |
| Last Update Date | 2024-09-30 |