| NPI | 1902515745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT030942) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-8466) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-11-28 |