| NPI | 1104465400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 40.0003232) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |