| NPI | 1063964252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 38859) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY KY6976) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2022-08-22 |