| NPI | 1811614928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0134937) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VT 104.0133987) |
| Enumeration Date | 2022-10-20 |
| Last Update Date | 2025-06-13 |