| NPI | 1841846896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 4747) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NE 1709) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2025-03-03 |