| NPI | 1679022727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8340) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA CP035064T) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2026-04-24 |