| NPI | 1639633092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 012138) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 011875) |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-12-17 |