| NPI | 1619531555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214260) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 296154) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2021-10-01 |