| NPI | 1528770120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216860) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 049651) |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2024-12-02 |