| NPI | 1114230778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305206540) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 13130) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2013-02-19 |