| NPI | 1700066636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT1699) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS 1699) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2025-08-27 |