| NPI | 1174007454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: 26698) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26698) |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2019-11-14 |