| NPI | 1508633082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT032225) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 11939) |
| Enumeration Date | 2023-12-05 |
| Last Update Date | 2024-07-24 |