| NPI | 1871077974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT012866) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: CO CP029955T) |
| 225100000X Physical Therapist (Licence: WA PT60887864) | |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2024-04-23 |