| NPI | 1548652829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 14013881) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: CT 630001528) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2023-02-08 |