| NPI | 1902900293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400002918) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0002918) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2020-02-06 |