| NPI | 1962047258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213132) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2020-07-21 |