| NPI | 1669140315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 048052-01) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 16165) |
| 225100000X Physical Therapist (Licence: NC P22867) | |
| 225100000X Physical Therapist (Licence: SC 12176) | |
| 225100000X Physical Therapist (Licence: VT 040.0134316) | |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2025-12-21 |