| NPI | 1780292748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28074) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT872650) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-09-08 |