| NPI | 1164542510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305202777) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY CP054734T) |
| 225100000X Physical Therapist (Licence: NC CP054571T) | |
| 225100000X Physical Therapist (Licence: OR CP044949T) | |
| 225100000X Physical Therapist (Licence: GA CP054449T) | |
| 225100000X Physical Therapist (Licence: TN CP054572T) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2026-04-09 |