| NPI | 1083080188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211775) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 29447) |
| 225100000X Physical Therapist (Licence: MD 25600) | |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2018-03-04 |