| NPI | 1265057509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P19606) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 8942) |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2021-09-07 |