| NPI | 1326634981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist Sports (Licence: WA PT61061339) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: IL 070.025215) |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2022-01-17 |