| NPI | 1649461336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2306602328) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA TE007448) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |