| NPI | 1962799049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207662) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT 36829) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2022-07-13 |