NPI | 1962130658 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 65764) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: MA PTL26302) |
Enumeration Date | 2022-08-10 |
Last Update Date | 2025-07-25 |