| NPI | 1124318415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23775) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6227) |
| 225100000X Physical Therapist (Licence: VA 2305206860) | |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2018-05-31 |