| NPI | 1114191947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212724) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 10078) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2019-07-31 |