| NPI | 1962983254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9123) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: MP 10665R) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2023-07-21 |