| NPI | 1396385720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212310) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9127) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-01-14 |