| NPI | 1053763342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 2039) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NE 3771) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2019-10-31 |