| NPI | 1003118704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210750) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 009952) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2016-12-19 |