| NPI | 1336795673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-6101) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: ID PT-6101) |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2020-09-15 |