| NPI | 1376241695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT43355) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 050079-01) |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2025-08-19 |