| NPI | 1295196046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210057) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 296519) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2026-05-29 |