| NPI | 1770323966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP042483T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P13250) |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2025-03-03 |