| NPI | 1104196724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-5826) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 27080) |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2018-07-18 |