| NPI | 1902943210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 4111-24) |
| Additional Taxonomies | 251E00000X Home Health (Licence: WI 4111-024) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2024-08-22 |