| NPI | 1477668788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207042) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT018301) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: PA PT018301) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2012-11-08 |