| NPI | 1609123736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210664) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0011838) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2020-03-17 |