| NPI | 1154696565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23012) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT020045) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2023-12-18 |