| NPI | 1558676122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305205396) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1023901) |
| Enumeration Date | 2010-08-08 |
| Last Update Date | 2010-08-08 |