| NPI | 1063036242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT6875) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MS PT6875) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |