| NPI | 1073822219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305206953) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT020941) |
| 225100000X Physical Therapist (Licence: NC P14839) | |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2014-09-04 |