| NPI | 1982147153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT5334) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006972) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2020-12-18 |