| NPI | 1457188633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216785) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 052540) |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2025-10-17 |