| NPI | 1972795490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP021985T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1158050) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2024-04-24 |