| NPI | 1104837236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 10631) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 005420) |
| 225100000X Physical Therapist (Licence: WA 00009247) | |
| 225100000X Physical Therapist (Licence: WY 1064) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-07-08 |