| NPI | 1770266785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT7612) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 15300) |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-12-12 |