| NPI | 1982390951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ CP032748T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OH PT020255) |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2024-09-23 |