| NPI | 1538122643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305203350) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 2857) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2008-04-01 |