| NPI | 1205517703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216854) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD T17128) |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2025-03-10 |