| NPI | 1407372782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 12045) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 11568) |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2020-04-14 |