| NPI | 1609909761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305206857) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 22020) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2012-02-16 |