| NPI | 1205129368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23780) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 11685-024) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2012-01-04 |