| NPI | 1083712392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 1116) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305004851) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-03-26 |