| NPI | 1225298169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-5383) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: ID PTA-220) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2018-08-30 |