| NPI | 1821859794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305004732) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI 3150) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: VA 2305004732) | |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305004732) | |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2025-06-16 |