| NPI | 1558856757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14087-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT009602L) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2018-06-29 |