| NPI | 1225590680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214898) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1316715) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2022-03-31 |