| NPI | 1013987080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213512) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD 16953) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-08-20 |