| NPI | 1487768537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400072387) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 2540) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2015-05-27 |