| NPI | 1902419757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28595) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT872755) |
| Enumeration Date | 2020-08-30 |
| Last Update Date | 2022-07-14 |