| NPI | 1386098697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0120002) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 8027) |
| 225100000X Physical Therapist (Licence: MA 22266) | |
| 225100000X Physical Therapist (Licence: MD 25792) | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2016-04-22 |