| NPI | 1619451929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2018029943) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR CP000071T) |
| 225100000X Physical Therapist (Licence: AL PTH9096) | |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2021-06-06 |