| NPI | 1205121290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 1652) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-2901) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2012-06-12 |