| NPI | 1982967642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211221) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2019-08-05 |