| NPI | 1417366329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208948) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003348) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-06 |