| NPI | 1073289559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 11225) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: TN 13776) | |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2022-05-02 |