| NPI | 1992567622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 042896) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-033677) |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-10-08 |