| NPI | 1972011989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 292596) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006900) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-01-12 |