| NPI | 1700399052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212441) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 23345) |
| 225100000X Physical Therapist (Licence: NC P17368) | |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2019-08-19 |