| NPI | 1003360686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211797) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26321) |
| 225100000X Physical Therapist (Licence: GA 012484) | |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2018-03-20 |