| NPI | 1811669641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28695) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2021033643) |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2024-01-10 |