| NPI | 1225193873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400002235) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 0400002630) |
| 225200000X Physical Therapy Assistant (Licence: VT 0410000278) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2007-07-08 |