| NPI | 1780433599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR 5498) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AR 4635) |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-08-01 |