| NPI | 1578931853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216302) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 006682) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2025-01-27 |