| NPI | 1104439462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8704) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0016887) |
| 225100000X Physical Therapist (Licence: CA 296420) | |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |