| NPI | 1871333518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216786) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 052864-01) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2024-09-30 |