| NPI | 1144714239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214011) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2020-11-04 |