| NPI | 1700365277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2022049942) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT026903) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2025-11-19 |