| NPI | 1790938280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305203423) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 0017901) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |