| NPI | 1164033502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 26062) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 007972) |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2025-04-08 |