| NPI | 1043254212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH2405) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: AL PTH2405) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2025-01-21 |