| NPI | 1962955369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14565-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26080) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2025-06-28 |