| NPI | 1730512310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211544) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023094) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2021-07-30 |