| NPI | 1497386650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0004186) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 14827-24) |
| 225100000X Physical Therapist (Licence: CO PTL.0016499) | |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2020-07-23 |