| NPI | 1265741730 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID 3836)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 9092)  | 
| Enumeration Date | 2010-10-01 | 
| Last Update Date | 2020-06-12 |