| NPI | 1053426072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 20608) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305204337) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2008-08-05 |