| NPI | 1073498788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 13045) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT43564) |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-26 |