| NPI | 1982256566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305212937) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2019-08-01 |