| NPI | 1972766830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2009010238) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 8124) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2022-04-12 |