| NPI | 1669882296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 14812) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: NC NU000011) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2022-01-05 |