| NPI | 1689307076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29249)  | 
| Additional Taxonomies | 225100000X Physical Therapist | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-07-05 | 
| Last Update Date | 2024-11-12 |