| NPI | 1083113856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT-4487) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210229) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |