| NPI | 1952970600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2021033586) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2021022040) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2021-08-20 |