| NPI | 1174179956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9993) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P19075) |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-12-02 |