| NPI | 1497108732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID 5066) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 61573) |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2018-02-08 |