| NPI | 1801129143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210444) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 12247) |
| 225100000X Physical Therapist (Licence: OR 6579) | |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2016-08-22 |