| NPI | 1790987584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 5288) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 7054) |
| 225100000X Physical Therapist (Licence: AL 2699) | |
| 225100000X Physical Therapist (Licence: NM 2555) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2023-07-11 |