| NPI | 1780183608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211748) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1301078) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-03-17 |