| NPI | 1619318847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1926) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-2746) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2017-05-18 |