| NPI | 1811479959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305212289) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305212289) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2023-10-24 |