| NPI | 1578035929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214232) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 12036) |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2023-01-09 |