| NPI | 1306888797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 001311) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT017424) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2008-08-05 |