| NPI | 1063617678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207993) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD T5989) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2022-09-23 |