| NPI | 1669732483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: UT 10152248-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-2702) |
| Enumeration Date | 2012-05-26 |
| Last Update Date | 2025-08-29 |