| NPI | 1790655223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P24486) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT-2411) |
| Enumeration Date | 2025-11-10 |
| Last Update Date | 2026-01-27 |