| NPI | 1205973013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: AZ 2977) |
| Additional Taxonomies | 2251S0007X Physical Therapist Sports (Licence: AZ 2977) |
| 225100000X Physical Therapist (Licence: AZ 2977) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-09 |