| NPI | 1205402013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 29190) |
| 225100000X Physical Therapist (Licence: PA PT029059) | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-01-31 |