| NPI | 1104368828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 11034) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 4019) |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2019-12-19 |