| NPI | 1154803971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 15142) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2023-10-09 |