| NPI | 1821495219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212734) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 41950) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2019-05-16 |