| NPI | 1407443724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029615) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63821) |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2021-11-15 |