| NPI | 1699797019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10610) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305203836) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |