| NPI | 1962921395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211035) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 293722) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2022-07-21 |