| NPI | 1770154882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029015) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63987) |
| 225100000X Physical Therapist (Licence: ID PT-7382) | |
| 225100000X Physical Therapist (Licence: SD 2297) | |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2021-07-09 |