| NPI | 1053923888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT200001209) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305214356) |
| Enumeration Date | 2020-08-22 |
| Last Update Date | 2025-08-06 |