| NPI | 1821569773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2018044340) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1304990) |
| 225100000X Physical Therapist (Licence: MS CP000067T) | |
| 225100000X Physical Therapist (Licence: NC 18154) | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-30 |