| NPI | 1699615765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT44222) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 008857) |
| Enumeration Date | 2026-03-30 |
| Last Update Date | 2026-03-30 |