| NPI | 1659807212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 09604R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT033435) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2025-08-04 |