| NPI | 1245595032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207802) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002781) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2013-02-12 |