| NPI | 1205829470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 5174) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 4946346-2401) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2008-10-12 |