| NPI | 1679909113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 005298) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12282-24) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2025-07-07 |