| NPI | 1982140976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC SC5964) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P2923) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2022-07-21 |