| NPI | 1811360340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2015039523) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2251123400000X) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2022-03-16 |