| NPI | 1992338107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA 028422) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 004187) |
| Enumeration Date | 2020-02-16 |
| Last Update Date | 2020-02-17 |