| NPI | 1174016141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216683) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: PA PT027001) | |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2024-09-04 |