| NPI | 1649903980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15915) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: WI 798879) |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2024-01-25 |