| NPI | 1790661452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT033638) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC CP050553T) |
| Enumeration Date | 2025-08-15 |
| Last Update Date | 2025-11-20 |