| NPI | 1700399813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 013035) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 1769) |
| Enumeration Date | 2017-11-10 |
| Last Update Date | 2025-12-15 |