| NPI | 1366077836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 63643) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI 4992) |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2020-09-23 |