| NPI | 1255900544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NV 6379) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 047259) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2024-10-24 |