| NPI | 1972912764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5795) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 5795-33) | |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2024-08-26 |