| NPI | 1154501559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305202344) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019006156) |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2007-11-14 |