| NPI | 1962038729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 22673) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1326358) |
| 225100000X Physical Therapist (Licence: NM PT5623) | |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |