| NPI | 1215365168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3289) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 8555982-2401) |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2013-10-30 |