| NPI | 1407248073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212286) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 10870) |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2018-12-19 |