| NPI | 1689300311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2022029304) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-8113) |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-09-12 |