| NPI | 1730622218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT33484) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT872023) |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2022-04-11 |