| NPI | 1245028190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 004766) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 009062) |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-04-29 |