| NPI | 1720141450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305206757) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 20693) |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2012-12-10 |