| NPI | 1164902052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14438-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2020007690) |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2021-02-09 |