| NPI | 1003993551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 14747) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT002812) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-03-31 |