| NPI | 1639961592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT43579) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305217057) |
| Enumeration Date | 2025-05-19 |
| Last Update Date | 2025-08-22 |