| NPI | 1063694636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 5472) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID 2234) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |