| NPI | 1629400775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2000162942) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 61088492) |
| 225100000X Physical Therapist (Licence: UT 86803692401) | |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2020-08-20 |