| NPI | 1134506397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 2305212101) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1253253) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2021-06-23 |