| NPI | 1255064812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 11384) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P24263) |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2026-03-13 |