| NPI | 1770248510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 11795618-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-7047) |
| Enumeration Date | 2021-11-06 |
| Last Update Date | 2021-11-06 |