| NPI | 1700604782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P21977) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 12982) |
| 225100000X Physical Therapist (Licence: ND 2787) | |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-09-30 |