| NPI | 1285317776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 20230302405) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT42253) |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2025-09-29 |