| NPI | 1902296825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12676) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023055) |
| 225100000X Physical Therapist (Licence: DE J1-0003226) | |
| 225100000X Physical Therapist (Licence: AL PTH12043) | |
| 225100000X Physical Therapist (Licence: OR 65520) | |
| 225100000X Physical Therapist (Licence: NC CP046865T) | |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2025-09-03 |