| NPI | 1417380916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210839) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1231829) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2017-02-10 |