| NPI | 1700613288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305217556) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT017362) |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2026-01-20 |