| NPI | 1508529256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 11564) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA PTL27592) |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2026-07-13 |