| NPI | 1275727745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 0336) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 336) |
| 225100000X Physical Therapist (Licence: AZ 2110) | |
| 225100000X Physical Therapist (Licence: ND 806) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2008-08-28 |