| NPI | 1306048764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 0000005485) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305212577) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2019-02-12 |