| NPI | 1831963172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN CP061919T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA CP052818T) |
| 225100000X Physical Therapist (Licence: KY CP052818T) | |
| 225100000X Physical Therapist (Licence: SC 12126) | |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2026-09-04 |