| NPI | 1629551288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P19917) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 041694-1) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2023-07-10 |