| NPI | 1225435233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209322) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 22483) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2015-12-07 |