| NPI | 1609340488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2019004000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2019000121) |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-03-06 |