| NPI | 1669106977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213578) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA CP010226T) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |