| NPI | 1316311533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400080856) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 009091) |
| Enumeration Date | 2015-11-27 |
| Last Update Date | 2015-11-27 |