| NPI | 1619642600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP007729T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT015442) |
| Enumeration Date | 2021-08-11 |
| Last Update Date | 2021-08-17 |