| NPI | 1194876524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305203081) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 23306) |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2012-09-17 |