| NPI | 1164849642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210919) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24918) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2018-04-05 |