| NPI | 1164186995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT42843) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL PTA21949) |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2025-05-31 |