| NPI | 1386012177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209773) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2022-02-04 |