| NPI | 1053370254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 006851) |
| Additional Taxonomies | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians (Licence: CT 006851) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2025-05-13 |