| NPI | 1417615972 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12799)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 048285)  | 
| 225100000X Physical Therapist (Licence: TN 15940)  | |
| Enumeration Date | 2021-12-02 | 
| Last Update Date | 2025-05-16 |