| NPI | 1831494152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2005000207) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2005000207) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2022-12-13 |