| NPI | 1558772640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 5203) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 9956) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2020-08-11 |