| NPI | 1316981228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305004781) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: 002606) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2008-09-26 |