| NPI | 1124685466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 1458324) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14583) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2022-10-25 |