| NPI | 1124120704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH4831) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT4184) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2021-07-12 |