| NPI | 1295746865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305205345) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: PA 016380) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: PA 016380) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2009-01-21 |