| NPI | 1639111719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210959) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 2471) |
| 225100000X Physical Therapist (Licence: HI 2625) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-05-19 |