| NPI | 1154655413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 24606) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17416) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2009-09-18 |