| NPI | 1629796248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214935) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT871920) |
| Enumeration Date | 2022-08-19 |
| Last Update Date | 2022-08-19 |