| NPI | 1790352961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT44362) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 24962) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2026-04-21 |