| NPI | 1386208890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 07833) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: LA 07833) |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-04-30 |