| NPI | 1225608425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH10627) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL 1-1158) |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-11-17 |