| NPI | 1104809870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 5358) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CA PT291463) |
| Enumeration Date | 2005-11-27 |
| Last Update Date | 2017-10-05 |