| NPI | 1093971137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208323) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 18058) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2015-08-18 |