| NPI | 1013459833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61979) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 12433) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-11-10 |