| NPI | 1174137913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 108113) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2020017790) |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2021-06-20 |