| NPI | 1962958470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 15161) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MT 15161) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2025-09-12 |