| NPI | 1225650294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P21623) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT34940) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2025-05-19 |