| NPI | 1063626158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 40389600) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 4719-24) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-10-31 |