| NPI | 1629816467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT031406) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT8601) |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-08-29 |