| NPI | 1558055574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO CP055952T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 29718) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2026-05-26 |