| NPI | 1760102156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305215542) |
| 225100000X Physical Therapist (Licence: MA 26437) | |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2023-11-28 |