| NPI | 1922780063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305217774) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT40476) |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2026-08-07 |