| NPI | 1578116026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC 2305212824) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA PT872449) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |