| NPI | 1164801361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28078) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305209452) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2022-10-14 |