| NPI | 1760925804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872035) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210785) |
| 225100000X Physical Therapist (Licence: ID PT4688) | |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |