| NPI | 1912891110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 050369) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT018062) |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-10-13 |