| NPI | 1982078390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 30975) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-5888) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2019-05-03 |