| NPI | 1235848045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0134494) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ LPT-034122) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2025-09-22 |