| NPI | 1205293826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI 4079) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS 5369) |
| 225100000X Physical Therapist (Licence: LA 0866OR) | |
| 225100000X Physical Therapist (Licence: CA 43597) | |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |