| NPI | 1467928440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 14431-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305212302) |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2020-10-15 |