| NPI | 1265959472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214166) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9048) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2021-08-03 |