| NPI | 1164504007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-2488) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 10557) |
| 225100000X Physical Therapist (Licence: ID PT-2992) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2015-09-19 |