| NPI | 1780295204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT39780) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: PA PT028668) |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2023-11-29 |