| NPI | 1952891343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT34597) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 10278) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2024-05-21 |