| NPI | 1972001261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14954) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 62615) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2020-09-11 |