| NPI | 1306014154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400055765) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 18017) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2012-12-06 |