| NPI | 1578581005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040-0002827) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH 3106) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |