| NPI | 1063151801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15843-24) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-10-12 |