| NPI | 1902344401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P17049) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT025793) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2026-02-04 |