| NPI | 1063899474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207202) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60961) |
| 225100000X Physical Therapist (Licence: TX 1254070) | |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2015-05-05 |