| NPI | 1124856521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MO 2025037665) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PT-PRV-29905) |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2025-10-10 |