| NPI | 1659380350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305005823) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-09-25 |