| NPI | 1679081590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211174) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17495) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-01-12 |