| NPI | 1104187517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE CP039225T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305004344) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2025-01-14 |