| NPI | 1194393124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 11563) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305214420) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2022-10-27 |