| NPI | 1649487828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT1390) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL0010328) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2026-01-29 |