| NPI | 1265618409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208474) |
| Additional Taxonomies | 2251N0400X Physical Therapist Neurology (Licence: SC 4143) |
| 225X00000X Occupational Therapist (Licence: SC 1870) | |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2016-05-17 |