| NPI | 1043601388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305202258) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 6045) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2015-02-09 |