| NPI | 1962030353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH10164) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2021-03-12 |