| NPI | 1164635967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7094) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 11092) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2016-11-02 |