| NPI | 1023137031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040-0003319) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 2399) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-08 |