| NPI | 1104056332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 01210) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 1553) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2009-07-22 |