| NPI | 1427665421 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215181) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT028780) | 
| Enumeration Date | 2020-09-24 | 
| Last Update Date | 2024-10-07 |