| NPI | 1255617494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 15723) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305207207) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2018-03-17 |