| NPI | 1801401039 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH10168)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT36346)  | 
| Enumeration Date | 2020-09-14 | 
| Last Update Date | 2022-08-10 |