| NPI | 1982120242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212656) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 24469) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2021-10-11 |