| NPI | 1548752181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12594) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26957) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2025-10-20 |