| NPI | 1194942425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 10756) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 0400003705) |
| 225100000X Physical Therapist (Licence: FL PT 25864) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2021-08-09 |