| NPI | 1396040184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305206907) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 18019) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2022-02-28 |