| NPI | 1861276446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P24649) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 051608) |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2026-09-02 |