| NPI | 1033207295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207517) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21269) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-08-07 |