| NPI | 1619510310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213314) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT272288) |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2019-11-15 |