| NPI | 1053040402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT42301) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225200000X Physical Therapy Assistant (Licence: DC PT200001391) | |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2024-09-26 |