| NPI | 1669962767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15949-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63086) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2022-11-03 |