| NPI | 1841153533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT44124) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT031469) |
| Enumeration Date | 2025-12-08 |
| Last Update Date | 2025-12-09 |