| NPI | 1205877511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305203604) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 11618) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2022-10-26 |