| NPI | 1104945211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 0061) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-808) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |