| NPI | 1881768679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305002051) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 15227) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |