| NPI | 1659979235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH7403) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 15326) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |