| NPI | 1306481551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213276) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: VA 2305213276) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2021-08-12 |