| NPI | 1174508121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 002526) |
| Additional Taxonomies | 174400000X Specialist (Licence: WV 002526) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2012-07-12 |