| NPI | 1164599395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 3333) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: WI 3333) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2015-01-02 |