| NPI | 1841716891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216343) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA 293512) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2024-05-24 |