| NPI | 1467813550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14083) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT024442) |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2019-03-08 |