| NPI | 1669529921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT1801) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MT 405) |
| 225100000X Physical Therapist (Licence: MT 1086PT) | |
| 225100000X Physical Therapist (Licence: PA PT008278L) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2022-01-11 |