| NPI | 1619469988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210770) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 003918) |
| Enumeration Date | 2018-06-03 |
| Last Update Date | 2019-10-23 |