| NPI | 1912776931 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501302531) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05015031A) | 
| Enumeration Date | 2024-01-02 | 
| Last Update Date | 2024-01-02 |