| NPI | 1407492309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215196) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 10011) |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2022-11-07 |