| NPI | 1154536829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2005023980) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR PT 2861) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |