| NPI | 1114755105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216671) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC CP033248T) |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-09-24 |