| NPI | 1053065532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2022004168) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| Enumeration Date | 2022-02-04 |
| Last Update Date | 2024-05-22 |