| NPI | 1144509167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207164) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004492) |
| 225100000X Physical Therapist (Licence: CT 8669) | |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2012-07-08 |