| NPI | 1992183404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305002585) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25252) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2015-05-15 |