| NPI | 1629379466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0003263) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 16638) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2025-10-13 |