| NPI | 1700295748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 11398) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT29260) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2025-09-03 |