| NPI | 1609437680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP032372T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 9677) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2024-07-16 |