| NPI | 1659940757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT7104) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MS PT7104) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2023-08-23 |