| NPI | 1710304886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 14695) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305208574) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2023-06-15 |