| NPI | 1891161170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15376) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: WI 2341) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2021-05-19 |