| NPI | 1255477121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 173021) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 3161) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2022-01-04 |