| NPI | 1912519901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 39378) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 4128) |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2025-12-22 |