| NPI | 1962677419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 21619) |
| Additional Taxonomies | 171W00000X Contractor (Licence: NM 3505) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2024-06-26 |