| NPI | 1508465626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2020033689) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA CP051025T) |
| 225100000X Physical Therapist (Licence: NE 4446) | |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2025-11-30 |