| NPI | 1790784478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 10424) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305203853) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2021-01-21 |