| NPI | 1790243624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 12676) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 27346) |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2020-01-27 |