| NPI | 1942435565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207102) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 24666) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2023-08-03 |