| NPI | 1902516438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI CP031765T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: 12245) |
| 225100000X Physical Therapist (Licence: TN 12245) | |
| Enumeration Date | 2022-11-23 |
| Last Update Date | 2024-06-03 |