| NPI | 1578932059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209464) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SD 1850) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |