| NPI | 1609245596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2012027638) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 15739) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2025-08-13 |