| NPI | 1043339849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2001001888) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 3407) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2015-03-18 |