| NPI | 1114389640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211770) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 291242) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: CA 291242) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2018-12-28 |