| NPI | 1659040269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2024025501) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT029692) |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2024-07-15 |