| NPI | 1982616397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 1871) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 7050) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2021-07-22 |