| NPI | 1154448165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AL PTH5702) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 16545) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2019-10-23 |