| NPI | 1215697511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214816) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT030059) |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2022-11-30 |