| NPI | 1053800136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 26955) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA 298022) |
| 225100000X Physical Therapist (Licence: VA 3405213732) | |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2023-05-17 |