| NPI | 1750623930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH6740) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 23553) |
| 225100000X Physical Therapist (Licence: SC 9077) | |
| 225100000X Physical Therapist (Licence: TN 451722) | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2024-03-28 |