| NPI | 1063699882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 004615) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10290-024) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2010-08-30 |