| NPI | 1114251519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 8629) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: CT 008629) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2016-04-07 |