| NPI | 1063418499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 3815) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 5359) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2017-03-23 |