| NPI | 1659526598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 01638) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 01638) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2011-07-05 |