| NPI | 1134712755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P20300) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 10558) |
| Enumeration Date | 2021-02-15 |
| Last Update Date | 2022-03-01 |