| NPI | 1124405949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21646) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 10661) |
| 225100000X Physical Therapist (Licence: CO 0012151) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2015-04-30 |