| NPI | 1215294582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 11530) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19726) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-04-11 |