| NPI | 1285392266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305217519) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 048332) |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2025-12-19 |