| NPI | 1720564461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213083) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 27138) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2023-06-20 |