| 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 |