| NPI | 1063793396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH6763) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT4877) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2013-06-10 |