| NPI | 1346590965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207561) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 6047) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2012-09-12 |