| NPI | 1629471149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212846) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT29461) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2026-05-05 |