| NPI | 1437987765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ CP049113T) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD 30054) |
| Enumeration Date | 2024-07-26 |
| Last Update Date | 2025-08-28 |