| NPI | 1639717606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT6779) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY CP000934T) |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2019-12-20 |