| NPI | 1265491609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA LA00776) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 0776) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2019-05-01 |