| NPI | 1164792487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 06712) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 033307) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |