| NPI | 1003196718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 2157) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 2759) |
| 225100000X Physical Therapist (Licence: SD 1544) | |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |