| NPI | 1912583105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0018606) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 15369-24) |
| 225100000X Physical Therapist (Licence: VT 040-0134255) | |
| 225100000X Physical Therapist (Licence: MD 28700) | |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2022-12-23 |