| NPI | 1265094197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212835) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24308) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2024-01-26 |