| NPI | 1659321891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT 2959) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AR PTA 1998) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-09-23 |