| NPI | 1841911989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 64529) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 31975) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2022-09-07 |