| NPI | 1700353430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 27511) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305212329) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2019-11-23 |