| NPI | 1780161752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 007891) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 295028) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2020-01-09 |