| NPI | 1649323460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 496) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 15216) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2021-04-27 |