| NPI | 1992397087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH10643) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-7244) |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2022-01-03 |