| NPI | 1235609678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305217565) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63362) |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2026-02-05 |