| NPI | 1942978770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2026015214) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2026-04-15 |