| NPI | 1801302013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211348) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT030090) |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2022-03-07 |