NPI | 1992390074 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: IL 070.025829) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 299336) |
2251S0007X Physical Therapist, Sports | |
Enumeration Date | 2021-03-01 |
Last Update Date | 2022-08-04 |