| NPI | 1366047169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216129) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 25008) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2024-03-13 |