| NPI | 1992355960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 13774) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1324092) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2021-08-05 |