| NPI | 1861048472 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872599) | 
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD 25890) | 
| Enumeration Date | 2019-08-11 | 
| Last Update Date | 2024-10-11 |