| NPI | 1912555210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 092123) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 4020) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2021-07-20 |