| NPI | 1295145936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9474) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL 24243) |
| Enumeration Date | 2014-05-03 |
| Last Update Date | 2020-10-02 |