| NPI | 1386779007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VT 040-0000912) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: VT 104-0000008) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-08 |