| NPI | 1619350204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH7752) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT5550) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2021-01-22 |