| NPI | 1952785305 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT870035) | 
| Additional Taxonomies | 174400000X Specialist (Licence: DE J1-0002594) | 
| Enumeration Date | 2015-07-15 | 
| Last Update Date | 2024-10-15 |