| NPI | 1497638514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT033446) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 363A00000X Physician Assistant (Licence: PA PT033446) | |
| Enumeration Date | 2025-07-28 |
| Last Update Date | 2025-07-28 |