| NPI | 1700923869 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT3406) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH3835) | 
| Enumeration Date | 2007-01-30 | 
| Last Update Date | 2021-04-19 |