| NPI | 1790919546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305205493) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: VA 2305205493) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2019-04-01 |