| NPI | 1538590930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207666) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2012027740) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2013-12-10 |