| NPI | 1821595927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE CP002604T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 09162R) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2020-07-27 |