| NPI | 1629589346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2017032365) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0015077) |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2017-10-20 |