| NPI | 1225742901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT033680) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT39820) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2026-07-01 |