| NPI | 1912299843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28281) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 18772) |
| 225100000X Physical Therapist (Licence: FL 24952) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2021-03-24 |