| NPI | 1407256316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2019016880) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2022-10-12 |