| NPI | 1336352764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204838) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: VA 0019004844) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2012-07-23 |