| NPI | 1366854655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213070) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P11731) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2020-05-05 |