| NPI | 1477396562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12963) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305216936) |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2025-08-21 |