| NPI | 1700617743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12480) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA CP042834T) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2025-03-20 |