| NPI | 1275040289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872382) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: VA 2305212294) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2024-11-18 |