| NPI | 1508412362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 110867) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT014194) |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2022-04-14 |