| NPI | 1174529580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 2015) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 03271) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2008-04-03 |