| NPI | 1891416822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2022028646) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2022-09-07 |