| NPI | 1790516755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P24621) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 014563) |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2026-04-08 |