| NPI | 1700066636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL CP05488OT) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS 1699) |
| 225100000X Physical Therapist (Licence: MS PT1699) | |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2026-04-09 |