| NPI | 1205146438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P22383) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL-10962) |
| 225100000X Physical Therapist (Licence: IA 081462) | |
| 225100000X Physical Therapist (Licence: SC 8384) | |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2025-04-03 |