| NPI | 1104150853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210938) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501016543) |
| 225100000X Physical Therapist (Licence: DC PT872155) | |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2019-08-23 |