| NPI | 1922792142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH11489) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL 2-1262) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2023-08-02 |