| NPI | 1457879249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212764) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306603051) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2022-07-21 |