| NPI | 1104902113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 174400000X Specialist (Licence: WV 2537) |
| 225100000X Physical Therapist (Licence: VA CP011718T) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2025-07-25 |