| NPI | 1548696016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208299) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT022963) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2013-09-17 |