| NPI | 1629551783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT5432) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-15068) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2019-07-24 |