| NPI | 1003317769 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 4051) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 13279PT) | 
| Enumeration Date | 2018-02-27 | 
| Last Update Date | 2024-01-10 |