| NPI | 1083182752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212482) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501304081) |
| 225100000X Physical Therapist (Licence: OH CP048985T) | |
| 225100000X Physical Therapist (Licence: MD 27719) | |
| Enumeration Date | 2018-11-11 |
| Last Update Date | 2025-09-25 |