| NPI | 1063363117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: LA 12261) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 12261) |
| Enumeration Date | 2026-02-05 |
| Last Update Date | 2026-02-05 |