| NPI | 1154588143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 0201) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 6935539-2401) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2017-01-09 |