| NPI | 1558162750 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 21803)  | 
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL 21803)  | 
| Enumeration Date | 2025-03-24 | 
| Last Update Date | 2025-03-24 |