| NPI | 1942717707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213299) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT37822) |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2025-07-17 |