| NPI | 1649817289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 12650) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH9565) |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |