| NPI | 1609489830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P9278) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0003157) |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2020-08-27 |