| NPI | 1578007589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212625) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26217) |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2019-03-06 |