| NPI | 1205175379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VT 40.0091542) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: VT 40.0091542) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2017-10-26 |