| NPI | 1194238444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212539) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 293957) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2021-06-23 |