| NPI | 1629262605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 3094) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 18052) |
| 225100000X Physical Therapist (Licence: VA 2305005033) | |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2011-12-19 |