| NPI | 1801263835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 27363) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305207244) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2021-12-16 |