| NPI | 1023623097 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216281)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046189)  | 
| 225100000X Physical Therapist (Licence: NJ 40QA02055200)  | |
| Enumeration Date | 2020-09-15 | 
| Last Update Date | 2024-10-14 |