| NPI | 1023605821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029124) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT-2025-0024) |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2025-02-13 |