| NPI | 1578689279 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 11124) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 8866) | 
| 225100000X Physical Therapist (Licence: MO 2003029328) | |
| Enumeration Date | 2007-03-22 | 
| Last Update Date | 2025-05-29 |