| NPI | 1104377720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P21919) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0003562) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2023-12-07 |