| NPI | 1215141130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 1999138147) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17878) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2009-06-09 |