| NPI | 1164711776 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT4484) | 
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MS OT2296) | 
| Enumeration Date | 2011-04-04 | 
| Last Update Date | 2025-08-26 |