| NPI | 1912632324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AR 4996) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: AR 4996) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2026-01-09 |