| NPI | 1801543053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 24104) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0018043) |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2025-11-08 |