| NPI | 1174004014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215614) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: 26460) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2024-06-12 |