| NPI | 1205107026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 2424) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 05640) |
| 225100000X Physical Therapist (Licence: ID 2510) | |
| 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-2474) | |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2019-12-12 |