| NPI | 1245575497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT002283E) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 27986) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2012-12-12 |