| NPI | 1245766369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 61823) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 10042123-2401) |
| 225100000X Physical Therapist (Licence: NC 16344) | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2017-05-10 |