| NPI | 1659788347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT4925) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 41395) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2019-07-11 |