| NPI | 1780304857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP035594T) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: MD 29173) | |
| 225100000X Physical Therapist (Licence: PA PT032388) | |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2024-11-27 |