| NPI | 1760936512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P16426) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 10089) |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2025-04-09 |