| NPI | 1154892511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT-4833) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24009) |
| 225100000X Physical Therapist (Licence: TX 1306228) | |
| 225100000X Physical Therapist (Licence: MI 5501018701) | |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2020-10-29 |