| NPI | 1194603795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP048965T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS 8049) |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2025-08-28 |