| NPI | 1710347869 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 32596) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210036) | 
| 225100000X Physical Therapist (Licence: DC PT871940) | |
| Enumeration Date | 2016-03-02 | 
| Last Update Date | 2022-10-05 |