| NPI | 1861826414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 17267) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10549) |
| 225100000X Physical Therapist (Licence: PA 23046) | |
| 225100000X Physical Therapist (Licence: SC 8553) | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2021-09-03 |