| NPI | 1528612769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 5668) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT5490) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2019-07-26 |