| NPI | 1740869866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1219477) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 25441) |
| 225100000X Physical Therapist (Licence: ME PT5563) | |
| 225100000X Physical Therapist (Licence: FL PT35481) | |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-06 |