| NPI | 1508256348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209213) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25345) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-02-03 |