| NPI | 1992402580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP018444T) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: GA PT016470) | |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2024-02-01 |