| NPI | 1457851206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ LPT-32013) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006384) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2025-11-14 |