| NPI | 1457647836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207963) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 26503) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2020-10-20 |