| NPI | 1790928794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212669) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT005254L) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2020-12-30 |