| NPI | 1154601169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215638) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT3555) |
| 225100000X Physical Therapist (Licence: FL PT30176) | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2023-04-19 |