| NPI | 1164201059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT40483) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305216701) |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2024-11-15 |