| NPI | 1982019519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: VA 2305208641) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25018) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2015-09-16 |