| NPI | 1972911196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-4827) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60611) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2022-07-21 |