| NPI | 1316563661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT8041) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT35857) |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL PT35857) | |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2025-10-20 |