| NPI | 1093058505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14170) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 1997-19) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2018-05-17 |