| NPI | 1275016750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PTA-LIC-15186) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MT 15141) |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2025-08-27 |