| NPI | 1922667864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 03302) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 2023) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2019-06-12 |