| NPI | 1225540453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 16224-24) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 2596-19) |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2023-09-14 |