| NPI | 1972228658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 303586) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305214923) |
| 225100000X Physical Therapist (Licence: MA 25837) | |
| 225100000X Physical Therapist (Licence: MI 5501020217) | |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2023-05-11 |