| NPI | 1821478652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204930) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25496) |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2022-08-29 |