NPI | 1679008445 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT32106) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305211596) |
225100000X Physical Therapist (Licence: NC 16830) | |
Enumeration Date | 2017-04-28 |
Last Update Date | 2021-06-01 |