| NPI | 1245616366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0111632) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: VT 040.0111632) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |