| NPI | 1821982364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID 9481215) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ID PTA-7604) |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2026-06-04 |