| NPI | 1699205542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 27406) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0003710) |
| 225100000X Physical Therapist (Licence: PA PT030950) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-09-28 |