| NPI | 1801361233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P22089) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 043268) |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2024-05-13 |