| NPI | 1962271916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029099) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-31625) |
| 225100000X Physical Therapist (Licence: CA 305320) | |
| Enumeration Date | 2024-01-01 |
| Last Update Date | 2024-01-01 |