| NPI | 1255980181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH9525) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: AL PTH9525) |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2021-08-23 |