| NPI | 1962400820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 00160R) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA PT00160R) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2022-10-14 |