| NPI | 1780454207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2024005556) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2023049891) |
| Enumeration Date | 2024-01-05 |
| Last Update Date | 2024-02-14 |