| NPI | 1912211616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 0110005098) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003789) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2024-03-22 |