| NPI | 1104410588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305207206) |
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: VA 2305207206) |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2021-02-25 |