| NPI | 1518979517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204729) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305204725) |
| 225100000X Physical Therapist (Licence: NC P12053) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2021-10-14 |