| NPI | 1154835460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 26809) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MD 26809) |
| 208100000X Physical Medicine & Rehabilitation (Licence: VA 2305211614) | |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2020-03-16 |