| NPI | 1508529256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2022009485) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT015343) |
| Enumeration Date | 2021-10-20 |
| Last Update Date | 2022-03-16 |