| NPI | 1649558982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64056) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC 871260) |
| 225100000X Physical Therapist (Licence: VA 2305206989) | |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2023-05-24 |