| NPI | 1417523762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215214) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 12287960-2401) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2025-08-18 |