| NPI | 1689185613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 29163) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 10044) |
| 225100000X Physical Therapist (Licence: MS PT6308) | |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2021-03-01 |