| NPI | 1629531850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2003012662) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: MO 2003012662) |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2024-06-25 |