| NPI | 1104062637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305205763) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009848) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2019-02-11 |