| NPI | 1770951923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209393) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25545) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2021-10-20 |