| NPI | 1235263542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040-0003677) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 006060) |
| 225100000X Physical Therapist (Licence: MA 15208) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-07-08 |