| NPI | 1700496536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA 029954) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 007996) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2021-11-24 |