| NPI | 1487074209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209097) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT 003337) |
| 225100000X Physical Therapist (Licence: SD 1756) | |
| Enumeration Date | 2014-04-19 |
| Last Update Date | 2015-01-24 |