| NPI | 1912251570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208566) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT27911) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2021-02-23 |