| NPI | 1619347150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA 027668) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS 5746) |
| 225100000X Physical Therapist (Licence: NC 15910) | |
| Enumeration Date | 2015-09-27 |
| Last Update Date | 2019-05-02 |