| NPI | 1144862939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213899) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: 296879) |
| Enumeration Date | 2019-10-13 |
| Last Update Date | 2020-09-30 |