| NPI | 1790161420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 26936) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT024584) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2020-06-14 |