| NPI | 1629654066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 36991) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT032216) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2026-06-13 |