| NPI | 1679436802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0015099) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD CP049430T) |
| Enumeration Date | 2025-12-04 |
| Last Update Date | 2025-12-04 |