| NPI | 1780759399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305205014) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT1875) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2014-11-05 |