| NPI | 1063898625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212626) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 12046) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2022-05-27 |