| NPI | 1366933541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH10386) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305211993) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2021-10-18 |