| NPI | 1053660845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24157) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6447) |
| 225100000X Physical Therapist (Licence: DE J1-0002902) | |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2016-12-12 |