| NPI | 1477679249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305205417) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305205417) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2022-04-26 |