| NPI | 1336499292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872127) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305209938) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2022-08-31 |