| NPI | 1679184691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213720) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 298457) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-16 |