| NPI | 1831963172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP052818T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 12126) |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2026-02-04 |