| NPI | 1306069851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 03319) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 10436-024) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |