| NPI | 1982129078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT872107) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2305213444) |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2022-10-25 |