| NPI | 1699267088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 10834645-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-5526) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-01 |