| NPI | 1013936582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 0791) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 5144) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-02-04 |