| NPI | 1306328984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9399) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 11950) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2019-05-30 |