| NPI | 1174067953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211598) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT012696) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2017-10-26 |