| NPI | 1063050318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05014087A) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: IN 06005936A) |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2021-04-28 |