| NPI | 1962860585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ME 5842) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1618) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2021-03-23 |