| NPI | 1043492952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 11866) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD 22335) |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2020-09-04 |