| NPI | 1124217799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 8215) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 0400003717) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2019-01-07 |