| NPI | 1285794123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: MO 104477) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 104477) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2011-12-06 |