| NPI | 1538223425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 2416) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305004758) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2007-07-08 |