| NPI | 1639621998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 4456) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NE 4456) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2025-06-03 |