| NPI | 1336389808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NC P13652) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 008409) |
| 225100000X Physical Therapist (Licence: VA 2305005645) | |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2015-09-14 |