| NPI | 1609440973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL pth10232) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AL 1234) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2021-05-19 |