| NPI | 1205115466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 895) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 797) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2012-05-16 |