| NPI | 1922514967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-4581) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60571822) |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2021-08-27 |