| NPI | 1568947612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14418-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1845) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2019-10-07 |