| NPI | 1811754609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: 27404) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CT 14355) |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2025-06-02 |