| NPI | 1700477296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 17596) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC P17596) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2025-05-06 |