| NPI | 1184761116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305205701) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 3175) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2022-06-01 |