| NPI | 1083200984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28673) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: VA 2305214660) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2023-12-12 |