| NPI | 1912626565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT031375) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 11463) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2026-01-26 |