| NPI | 1710555628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400134280) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 14278) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2026-05-28 |