| NPI | 1962048637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT-5243-0) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305212349) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2022-10-21 |