| NPI | 1336628437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 12453) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0134030) |
| 225100000X Physical Therapist (Licence: VA 2305212209) | |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2019-10-01 |