| NPI | 1528629102 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 10810) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17498) | 
| Enumeration Date | 2019-06-25 | 
| Last Update Date | 2019-06-25 |