| NPI | 1578817458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212725) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P14009) |
| 225100000X Physical Therapist (Licence: CA 43564) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2019-07-04 |