| NPI | 1245794668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 16465) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: TN 4842) |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2025-08-01 |