| NPI | 1679142798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28952) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305214320) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2022-05-26 |