| NPI | 1174743496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400083510) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT22294) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2019-09-03 |