| NPI | 1558924019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305203139) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 12359) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-05-13 |