| NPI | 1104199777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 11677) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305205672) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2026-03-30 |