| NPI | 1164606422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 9570) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 3644) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2012-02-23 |