| NPI | 1336230283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CO 10991) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 7431) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2011-09-14 |