| NPI | 1013977545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204255) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA DAPT000324) |
| 225100000X Physical Therapist (Licence: PA PT015366) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2007-07-08 |