| NPI | 1710293550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH10725) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA21539) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2022-05-23 |