| NPI | 1992770317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 10288) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305204689) |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2008-11-24 |