| NPI | 1689798183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305206049) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21655) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2012-10-10 |