| NPI | 1124219423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 578) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 6556) |
| 225100000X Physical Therapist (Licence: NC 4050) | |
| 225100000X Physical Therapist (Licence: AK 929) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-09-08 |