| NPI | 1194139774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA 023294) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305213121) |
| 225100000X Physical Therapist (Licence: TN 12595) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2019-10-31 |